Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 35.068336 | OH |
NPI | 1003993098 |
---|---|
Provider Name | Hiresadarahalli C Nataraj |
First Address | Louisville, KY 40223-2992 |
Second Address | Dublin, OH 43016-9609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 11/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0153060 | (05) | OH |
030005113 | RAILROAD MEDICARE (01) | OH |
G03463 | (02) |